14D2115339 CLIA NUMBER - HEARTLAND HEALTH SERVICES - OLT

Laboratory Demographics

CLIA Number: 14D2115339

Facility Name: HEARTLAND HEALTH SERVICES - OLT

Facility Address:
19 OLT AVE
PEKIN, IL
ZIP 61554
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Facility Phone Number: 309 680-7600

Facility Type: Federally Qualified Health Center

Certificate Type: Microscopy

NPI Number: 1336193861

Taxonomy: 261QF0400X - Clinic/Center

CLIA Record

Field Name	Field Value
CLIA Number	14D2115339
LAB Type	Federally Qualified Health Center
Facility Name	HEARTLAND HEALTH SERVICES - OLT
Street	19 OLT AVE
City	PEKIN
State	IL
ZIP	61554
Phone	309 680-7600
CertificateType	3
CertificateEffectiveDate	7/5/2022
CertificateExpirationDate	7/4/2024
FacilityType	PPMP

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This page was last updated on: 4/23/2024